F-FDG PET/CT诊断胆管细胞癌分期价值研究

doi:10.3969/j.issn.1672-5069.2021.03.031

摘要/Abstract

摘要： 目的探讨采用¹⁸F-氟代脱氧葡糖糖(¹⁸F-FDG)正电子发射计算机断层扫描(PET/CT)诊断肝内胆管细胞癌(ICC)分期的效能。方法 2017年1月～2020年1月我院收治的107例ICC患者和同期107名体检且身体健康的志愿者,接受¹⁸F-FDG PET/CT检查,行TNM分期评估,勾画感兴趣区域,计算最大标准摄取值(SUV_max)。所有患者接受手术治疗,术后行组织病理学检查。结果 Ⅰ期ICC组SUV_max值为(4.1±1.1)、Ⅱ期为(7.2±1.5)、Ⅲ期为(9.3±1.8),均显著高于健康组的【(2.0±0.9),P＜0.05】;¹⁸F-FDG PET/CT检查显示在107例ICC患者中,TNM分期Ⅰ期为35例,Ⅱ期为47例,Ⅲ期为25例,术后组织病理学检查显示Ⅰ期、Ⅱ期和Ⅲ期分别为34例、48例和24例;经一致性分析,¹⁸F-FDG PET/CT诊断ICC患者TNM Ⅰ期的灵敏度为0.968,特异度为0.500,准确率为0.914,阳性预测值为0.938,阴性预测值为0.667,诊断Ⅱ期的灵敏度为0.976,特异度为0.667,准确率为0.956,阳性预测值为0.976,阴性预测值为0.667,诊断Ⅲ期的灵敏度为0.955,特异度为0.667,准确率为0.920,阳性预测值为0.955,阴性预测值为0.667。结论 ¹⁸F-FDG PET/CT检查能够帮助诊断ICC,并协助TNM分期的评估,具有较高的临床应用价值。

关键词: 肝内胆管细胞癌, ¹⁸F-氟代脱氧葡糖糖, 正电子发射计算机断层扫描, TNM分期, 诊断

Abstract: Objective The aim of this study was to investigate the diagnostic efficacy of ¹⁸F-FDG PET/CT scan in patients with intrahepatic cholangiocarcinoma (ICC).Methods 107 patients with ICC and 107 healthy persons underwent ¹⁸F-FDG PET/CT scan between January 2017 and January 2020, and the TNM staging of tumor was evaluated and the standard uptake value maximum (SUVmax) was culculated. All patients received tumor resection.Results The SUVmax in patients with ICC stage Ⅰ was (4.1 ± 1.1), in patients with stage Ⅱ was (7.2 ± 1.5), and in patients with stage Ⅲ was (9.3 ± 1.8), all significantly higher than [(2.0 ± 0.9) , P<0.05] in healthy persons; the FDG PET/CT scan showed TNM stage Ⅰ in 35 cases, stage Ⅱ in 47 cases, and stage Ⅲ in 25 cases, and the post-operational histopathological examination demonstrated TNM stage Ⅰ, stage Ⅱ and stage Ⅲ were34 cases, 48 cases and 24 cases, respectively; the sensitivity (Se) of ¹⁸ F - FDG PET/CT scan in the diagnosis of patients with ICC TNM stage Ⅰ was 0.968, the specificity (Sp) was 0.500,the accuracy (Ac) was 0.914, the positive predictive value (PPV) was 0.938, and the negative predictive value (NPV) was 0.667, in the diagnosis of patients with ICC TNM staging Ⅱ, the Se was 0.976, the Sp was 0.667, the Ac was 0.956, the PPV was 0.976, and the NPV was 0.667, and in the diagnosis of patients with ICC TNM staging Ⅲ, the Se was 0.955, the Sp was 0.667, the Ac was 0.920, the PPV was 0.955, and the NPV was 0.667.Conclusion The application of ¹⁸F-FDG PET/CT scan is helpful for the diagnosis and assessment of TNM stage in patients ICC.

Key words: Intrahepatic cholangiocarcinoma, ¹⁸F-fluorodeoxyglucose, Positron emission computed tomography, TNM staging, Diagnosis

王耀政, 王瑜琳, 林毅. F-FDG PET/CT诊断胆管细胞癌分期价值研究[J]. 实用肝脏病杂志, 2021, 24(3): 427-430.

Wang Yaozheng, Wang Yulin, Lin Yi. Diagnostic efficacy of ¹⁸F-FDG PET/CT scan in patients with ntrahepatic cholangiocarcinoma[J]. Journal of Practical Hepatology, 2021, 24(3): 427-430.

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